* 1. How easy or difficult was it to access, download and print the Ice-Breaker Form?

* 2. How easy or difficult was it to answer the questions in the Ice-Breaker Form?

* 3. What could have been done to improve your experience of downloading, printing and completing the Ice-Breaker Form?

* 4. Who did you discuss the details you'd written on the Ice-Breaker form with?

* 5. Before you discussed the Ice-Breaker with the person, how much did you trust them you to make decisions that are in your best interests?

* 6. How well did the person actively listen to your needs?

* 7. How well did the person answer your questions?

* 8. What treatment options did the person suggest?

* 9. How well did the person explain your treatment options?

* 10. How well did the person explain your follow-up care?

* 11. How satisfied or dissatisfied were you with the amount of time the person spent with you addressing your needs?

* 12. Overall, how satisfied or dissatisfied were you with the conversation you had with the person about what you'd written on the Ice-Breaker Form?

* 13. Overall, how would you rate the care you received from the person you spoke with about the Ice-Breaker Form?

* 14. AFTER you discussed the Ice-Breaker with the person, how much did you trust them you to make decisions that are in your best interests?

* 15. What could have been done to improve your experience of discussing what you'd written on the Ice-Breaker Form with the person you spoke with?

* 16. Overall, how would you rate the usefulness of the Ice-Breaker Form to start a conversation about the issues you wrote on the form?

* 17. How satisfied or dissatisfied were you with the treatment options you tried?

  Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied N/A
Cognitive Behavioural Therapy (CBT)?
Other therapy?
Support from social care (Social Services)?
Practical support from a Professional Hoarding Practitioner or Professional Organiser?
Safe and Well (Home Fire Safety) visit from the Fire & Rescue Service
Attend a Hoarding Support Group?
Attend another Support Group?
Phone a Helpline?
Emotional Freedom Technique (EFT)?

* 18. How long did you persevere with the treatment options?

  1 session 2-5 sessions 6-10 sessions 11-20 sessions More than 20 sessions Still ongoing  N/A
Cognitive Behavioural Therapy (CBT)?
Other therapy?
Support from social care (Social Services)?
Practical support from a Professional Hoarding Practitioner or Professional Organiser?
Safe and Well (Home Fire Safety) visit from the Fire & Rescue Service
Attend a Hoarding Support Group?
Attend another Support Group?
Phone a Helpline?
Emotional Freedom Technique (EFT)?

* 19. How much has the therapy helped you overcome the difficulties you were experiencing that were affecting your health?

* 20. How much has your health improved as a result of the therapy you chose?

* 21. How much would you rate the Ice-Breaker form and recommend other people to use it to get help and support?

T